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Bilateral Femoral Capital Physeal Fractures in Young Male Cat

VETERINARIAN SPECIALTY CASE STUDY

On presentation Gunner was having trouble standing/bearing weight on is pelvic limbs, right especially. He was reluctant to walk, appeared paretic in the hind limbs and would lay down on his right side when positioned to stand in order to evaluate gait.

1. Referral

“Gunner” a 1.5 year old, male neutered DSH was presented to the ASG emergency service for an acute pelvic limb lameness. Gunner’s owner accidently kicked him when she went to swing her legs on to the sofa. She reports that she caught Gunner with her foot somewhere near his back end. Gunner was noted to be lame after the incident and was presented to ASG shortly thereafter. Gunner is an otherwise healthy cat with no other pertinent medical history. He is not currently on any medications.

2. Examination

On presentation Gunner was having trouble standing/bearing weight on is pelvic limbs, right especially. He was reluctant to walk, appeared paretic in the hind limbs and would lay down on his right side when positioned to stand in order to evaluate gait. His conscious proprioception was intact however delayed in his right pelvic limb. On orthopedic exam he was significantly painful on palpation and manipulation of his coxofemoral joints, bilaterally. His physical exam findings were otherwise unremarkable.

3. Diagnostics

“Gunner” remained hospitalized overnight on IV fluids and a Fentanyl CRI for pain control. He was transferred to our surgery service the following morning for a Bilateral Femoral Head and Neck Ostectomy procedure with Dr. Michael Huber, DVM MS, DACVS. Gunner was discharged with buprenorphine for pain control. Discharge instructions included two weeks of limited activity and passive range of motion therapy (flexion/extension of the hips 2-3 times daily for 10 minutes). It is thought that “Gunner” has recovered well.

4. Discussion

Capital Physeal Fractures occur most commonly in young overweight cats (< 10 months old) that have been neutered prior to 6 months of age. Delayed physeal closure and cartilage abnormalities may increase the susceptibility of these type of fractures for these cats.

Most animals are presented for an acute non weight bearing lameness, with or without significant or minor trauma. Proximal femoral physeal fractures are generally Salter I or Salter II fractures where distal femoral physeal fractures are generally Salter II fractures.

Standard ventrodorsal and mediolateral projections of the femur and required to confirm diagnosis. A capital physeal fracture with minimal displacement can be difficult to detect with an extended limb ventrodorsal projection. Thus a ventrodorsal projection with the limbs in a “frog position” can be very important to confirm diagnosis.

Dr. Roubina Honarchian’s interest in Emergency and Critical Care springs from her deep-seeded concern for love, justice, and animal neglect. Her specific veterinary areas of interest are extensions of those causes: pathology, shelter medicine, and internal medicine are among the veterinary practices she cares about most.